Comparison of traumatic Stress, anxiety, depression, and sleep quality in psoriasis patients affected by earthquake with healthy control group affected by earthquake

In recent years, some studies have been conducted to investigate the relationship between skin diseases such as psoriasis and mental disorders. A few studies have explored the prevalence of psoriasis during wartime and the relationships between psoriasis and war-induced PTSD. However, there is very little research in the literature on the relationship between psoriasis and post-traumatic stress disorder (PTSD), traumatic stress, depression, anxiety, and sleep quality triggered by earthquakes. Psoriasis is a condition that can have profound effects on the psychological and social aspects of the patient, particularly due to its physical visibility. In these patients, quality of life may deteriorate, and they may experience stigma similar to individuals with mental health disorders. Psoriasis patients can also suffer from various mental health conditions such as depression, anxiety disorders, PTSD, and insomnia. Additionally, various mental health disorders can exacerbate the onset and severity of psoriasis flare-ups. The co-occurrence of psoriasis and mental disorders can negatively impact the progression of both conditions. The early diagnosis of mental disorders in psoriasis patients and the identification of risk factors may be important for improving health-related quality of life and clinical outcomes. Studies have shown the impact of stressful life events on the onset, exacerbation, and relapse of psoriasis. In this study, we aimed to compare the levels of earthquake impact on psoriasis patients affected by the earthquakes of February 6, 2023, with those of a healthy control group affected by the same earthquakes. Our study is a cross-sectional, comparative survey study, and the sample of the present study consists of a group of psoriasis patients affected by the earthquake who applied to the dermatology clinic of Adıyaman University Training and Research Hospital, as well as a healthy control group affected by the earthquake. Data were collected through individual interviews and examinations using a Sociodemographic Data Form, the Beck Depression Inventory, the Beck Anxiety Scale, the Pittsburgh Sleep Quality Index (PSQI), and the DSM-5 PTSD Checklist. The healthy control group was composed of individuals affected by the February 6 earthquakes who had no psychiatric or dermatological conditions. Data analysis was performed using the SPSS 24.0 software package, with statistical significance set at a p-value of 0.05 or lower. Based on inclusion and exclusion criteria, the study included 86 patients (52 women, 34 men) and 86 healthy controls (54 women, 32 men). There was no statistically significant difference between the control group and the patient group in terms of average age and gender distribution (p>0.05). It was found that the educational and employment status of the patient group was lower compared to the control group (p<0.001). However, no statistically significant difference was found between the psoriasis patient group and the healthy control group in terms of marital status (p=0.166). A family history of dermatological disease was found to be significantly higher in the psoriasis patient group compared to the healthy control group (p=0.013). Among those without PTSD, the prevalence of systemic diseases was significantly higher compared to those with PTSD (p=0.032). In the PTSD group, a family history of dermatological disease was also significantly higher compared to those without PTSD (p=0.032). Additionally, the average age was significantly higher in the group without PTSD compared to the group with PTSD (p=0.002). In the PTSD group, the average scores for the Beck Depression Inventory, Beck Anxiety Scale, and Pittsburgh Sleep Quality Index (PSQI) were found to be significantly higher compared to the group without PTSD (p=<0.001, p=<0.001, p=0.005, respectively). In the PTSD group, the average scores for PTSD re-experiencing, PTSD avoidance, PTSD negative mood, and PTSD hypervigilance were also significantly higher compared to the group without PTSD (p=<0.001, p=<0.001, p=<0.001, p=<0.001, respectively). In psoriasis patients, a positive significant correlation was found between age and disease duration (p=0.014). Additionally, a negative significant correlation was observed between age and the average scores for the Beck Depression Inventory, Beck Anxiety Scale, and PSQI (p=0.008, p=0.005, p=0.004, respectively), as well as between age and PTSD re-experiencing, PTSD avoidance, PTSD negative mood, and PTSD hypervigilance scores (p=0.001, p=0.049, p<0.001, p=0.000, respectively). In psoriasis patients, a positive significant correlation was found between the Beck Depression Inventory scores and the average scores for the Beck Anxiety Scale and PSQI (p<0.001 for both), as well as between PTSD re-experiencing, PTSD avoidance, PTSD negative mood, and PTSD hypervigilance scores (p<0.001 for all). A positive significant correlation was also observed between Beck Anxiety Scale scores and the average scores for the Beck Depression Inventory and PSQI (p<0.001 for both), as well as with all PTSD subscale scores (p<0.001). Additionally, a positive significant correlation was found between the average PSQI scores and all PTSD subscale scores (p<0.001) in psoriasis patients. The findings of our study indicate that in the psoriasis group, as age increases, the prevalence of depression, anxiety, insomnia, and PTSD decreases. In the PTSD group, levels of depression and anxiety were found to be higher, and sleep quality was worse. Additionally, there were no significant differences in the levels of depression, anxiety, PTSD, or sleep quality between psoriasis patients and healthy controls. Keywords: Earthquake, psoriasis, post-traumatic stress disorder